Sarmiento-Medina María Inés, de Amaya Miryam Puerto, Villamizar-Gómez Licet, González-Coba Andrea Carolina, Guzmán-Barajas Laura
Vicerrectoría de Investigaciones, Fundación Universitaria de Ciencias de la Salud, Bogotá D.C, Colombia.
Facultad de Tecnologías en Salud, Fundación Universitaria de Ciencias de la Salud, Bogotá D.C, Colombia.
PLoS One. 2024 Feb 5;19(2):e0297579. doi: 10.1371/journal.pone.0297579. eCollection 2024.
Cervical cancer, primarily caused by Human Papillomavirus (HPV) transmission through sexual contact, necessitates comprehensive strategies to combat its impact on women's health. Yet, certain underserved populations, such as low socioeconomic and ethnic minority groups, encounter barriers in accessing timely interventions and early diagnosis. This cross-sectional study was conducted with the aim of assessing HPV prevalence, genotype distribution, and co-infections among 280 adult women residing in a Colombian Indigenous Reserve within the Amazon region. The research adhered to a community-centric approach that respected cultural norms, native languages, and Indigenous authorities' permission. The study revealed an overall HPV infection prevalence of 31.1% (n = 87, 95% CI 25.7-36.8), with 22.5% (n = 63, 95% CI 17.7-27.8) of women infected by at least one high-risk HPV genotype and 15.0% (n = 42, 95% CI 11-19.7) infected by at least one LR genotype. These results align with the findings of other Colombian studies. Notable high-frequency genotypes included 16, 52, 66, 56, and 68, with the most common combinations being [66-52] and [66-58]. The study also assessed the prevalence of HPV vaccination, revealing a rate of 22.9%, lower than the national average. In vaccinated women, the prevalence of genotypes 16 and 18 was significantly reduced, as anticipated. Importantly, it was observed that 57.1% of all high-risk HPV infections could have been prevented with the use of the nonavalent vaccine. These findings underscore the critical need to enhance adherence to early cervical cancer detection and monitor positive cases to evaluate high-risk HPV persistence. Efforts should be directed toward continuing vaccination coverage against high-risk HPV 16 and 18 with the quadrivalent vaccine, while also striving to make the nonavalent vaccine accessible for inclusion in large-scale public health programs. Additionally, the study did not identify a specific pattern of co-infection. The study emphasizes the significance of adopting a locally tailored epidemiological approach to guide and promote cervical cancer prevention efforts in Indigenous communities.
宫颈癌主要由通过性接触传播的人乳头瘤病毒（HPV）引起，因此需要采取综合策略来应对其对女性健康的影响。然而，某些服务不足的人群，如社会经济地位较低的群体和少数族裔群体，在获得及时干预和早期诊断方面面临障碍。本横断面研究旨在评估居住在亚马逊地区哥伦比亚一个原住民保护区的280名成年女性中的HPV流行率、基因型分布和合并感染情况。该研究采用了以社区为中心的方法，尊重文化规范、母语和原住民当局的许可。研究显示，HPV总体感染率为31.1%（n = 87，95%可信区间25.7 - 36.8），22.5%（n = 63，95%可信区间17.7 - 27.8）的女性感染了至少一种高危HPV基因型，15.0%（n = 42，95%可信区间11 - 19.7）的女性感染了至少一种低危基因型。这些结果与其他哥伦比亚研究的结果一致。值得注意的高频基因型包括16、52、66、56和68，最常见的组合是[66 - 52]和[66 - 58]。该研究还评估了HPV疫苗接种率，结果显示为22.9%，低于全国平均水平。正如预期的那样，在接种疫苗的女性中，16型和18型基因型的流行率显著降低。重要的是，观察到所有高危HPV感染中有57.1%可以通过使用九价疫苗预防。这些发现强调了加强对早期宫颈癌检测的依从性并监测阳性病例以评估高危HPV持续存在的迫切需求。应努力继续使用四价疫苗针对高危HPV 16和18进行疫苗接种覆盖，同时也努力使九价疫苗能够用于大规模公共卫生项目。此外，该研究未发现特定的合并感染模式。该研究强调了采用因地制宜的流行病学方法来指导和促进原住民社区宫颈癌预防工作的重要性。
